The efficacy of negative pressure wound therapy compared with conventional dressing in treating infected diabetic foot ulcers: a randomized controlled trial

Introduction Despite advances made in diagnosing and controlling diabetes mellitus (DM), treatment of diabetic foot ulcers (DFUs) is still among challenges faced by physicians. Negative pressure wound therapy (NPWT) is one of newer modalities proposed in the treatment of DFUs. However, there is lack of evidence to support its mileage in this regard. This study was conducted with the aim of assessing the efficacy of NPWT in healing process of DFUs. Materials and methods Sixty patients with DM were randomly allocated into two groups consisting of 30 patients each: the intervention group received sub-atmospheric pressure of - 75 to - 100 mmHg (5 min on, 2 min off) with dressings changed every 48 h, and the control group was treated with silver sulfadiazine dressings, changed twice daily. Patients were followed up until complete closure of ulcers, with a mean duration of 3 months. Results Of the total 60 patients, 27 patients (45%) were females. Most of the patients in both groups had DFUs of grade 2 according to Wegner's classification. Rate of healing of the ulcers was significantly higher by using NPWT (p-value 0.01). NPWT also caused a significant reduction in ulcer surface area, depth, size, major and minor amputations, and disability duration (p-values 0.008, 0.002, 0.02, 0.03, and 0.01, respectively). No significant decrease in occurrence of complications was seen with NPWT. Conclusion NPWT seems to be more efficacious than conventional dressing in treating infected DFUs.